More reports that Omicron appears to cause mild Covid - but too early to say for sure, experts warn

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  • There are early signs the Omicron variant does not cause more severe illness than the Delta variant.
  • However, experts have cautioned that the variant has only recently been discovered - and data will tell whether this is the case.
  • NICD officials and GPs in Gauteng have noticed that vaccinated patients tend to fare better than the unvaccinated.

With the news of a new coronavirus variant circulating in South Africa, officials and health practitioners are concerned that it may lead to more severe disease, compared with previous variants.

But doctors treating patients infected with the variant, named Omicron, ahead of South Africa's fourth wave, say their patients have mostly displayed mild symptoms.

Speaking at a media briefing on Monday, Dr Unben Pillay, a general practitioner in Gauteng, said that even though doctors in the province - where cases have risen sharply over the last several days – have seen an increase in cases, these cases have tended to be very mild.

"We've seen patients present with flu-like symptoms, dry cough, fever, night sweats and a lot of general body pains and malaise," he said.

However, Pillay cautioned: "We haven't seen a big increase in hospital cases or in pulmonary complications … but it is early days."

Similarly, Dr Angelique Coetzee, a Tshwane medical doctor and board chairperson of the South African Medical Association (SAMA), told News24 over the weekend that her Covid patients, so far, had not shown any severe symptoms, or the need for hospital treatment.

"This is not only my own account. I consulted with other doctors in Atteridgeville, Midrand and so on, and they're seeing exactly what I am seeing. The symptoms are mild, and that's the most important message," she said.

Like Pillay, Coetzee said the situation might change over time.

Anecdotal reports

The two doctors' observations were in line with what the scientific panel presented during the briefing. 

One of the scientists, epidemiologist and director of the Centre for the AIDS Programme of Research in South Africa, Professor Salim Abdool Karim, said anecdotal evidence suggests people infected with Omicron have similar symptoms as those who are infected with Delta, which drove SA's third Covid wave. Cases have occurred mainly in younger people, he said.

"What we are seeing is anecdotal information suggesting similar presenting illnesses, mainly in younger people for obvious reasons (younger people are less vaccinated), so you will see more cases there," he said.

Abdool Karim added: "We've seen some anecdotal information. We've seen clinicians commenting. But you have to understand that patients coming into a clinical setting are biased in terms of their severity and what we are seeing.

"We simply do not have sound, reliable data on the clinical presentation, but we have no red flags that have been raised so far. But we can't be complacent, we have to monitor the situation."

We have to await more data

In a series of tweets on Friday, infectious disease expert Dr Richard Lessells highlighted that only time will tell whether the new variant causes more disease severity.

He said that because Omicron is a recently discovered variant, scientists and doctors can't know for certain until more data on hospitalisation becomes available in the next few weeks. 

"Observations from clinicians on the ground are always important, and we lean heavily on them, but we need to be cautious about jumping on early reports that all cases with this variant are mild," he wrote.

The increase in cases in Gauteng is very recent and off a low base, and most of the early spread of the virus was among younger people.

"So, with this, and the time lag for infections to progress to severe disease and hospitalisation, we would only expect to see the impact on hospitalisations in the next few weeks," he said.

He also told News24: "It's just that there's a lot flying around from clinicians saying that all cases are mild. I think we need to exercise a bit of caution about that because this is largely affecting the younger age group - and, as you might know, they are not at risk of getting severely sick anyway," he said.

Vaccinated patients fare better

Pillay said doctors managing Covid patients have observed that those with breakthrough infections (contracting the disease after vaccination) "are managed at home and tend to do much better" than the unvaccinated. 

"We will know a lot more in terms of what the patients' presentation features are as we go along," he said.

Hospitalised patients mostly unvaccinated

In the Tshwane metro, where cases have climbed since mid-November, 87% of all patients hospitalised with Covid are unvaccinated, News24 reported.  

This was according to Dr Wassila Jassat, from the National Institute for Communicable Diseases (NICD), who said there have been 455 hospital admissions in the Tshwane area in the last two weeks. Their surveillance indicated that unvaccinated patients fared worse than vaccinated ones, Jassat said. 

With SA headed into the holiday season, the biggest challenge is going to be preventing super-spreader events and ensuring that people reduce the risk of transmission, particularly indoors, said Abdool Karim.

He added: "Even though we're likely to see more reinfections and breakthrough infections, vaccinated people are less likely to have severe Covid."

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